8%) followed by sulfonylurea (72.6%), α-glucosidase inhibitors (26.4%), thiazolidinedione (24.0%), insulin (20.6%) and dipeptidyl peptidase-IV inhibitors (13.6%). A similar pattern LDC000067? of drug use was reported earlier in a small study from northern India.15 Our study shows that T2DM participants consume high CHO in their diet, which has a direct effect on postprandial blood glucose and insulin response.7 In addition to dietary and lifestyle modifications, multiple therapeutic strategies like AGIs, SU, Insulin, DPP4-I and glucagon-like-peptide—1

analogues may benefit T2DM participants. Metformin was the most commonly used antidiabetic agent in our study. It is a hypoglycaemic agent that has been widely used in clinical practice for more than half a decade to treat diabetes. It is as safe and effective as monotherapy and can also be used in combination with any other hypoglycaemic agent for treatment of diabetes. Furthermore, it is cost-effective, reduces weight and is weight neutral. It has less incidence of hypoglycaemia as compared to sulfonylurea and insulin and exerts beneficial effects on lipids.16 17

The second most commonly used medication was sulfonylurea. Among sulfonylureas, glimepiride was the one most commonly used. The higher usage of sulfonylurea is probably due to the need to rapidly control the glucose levels and the preference for glimepiride could be due to its lower propensity to cause hypoglycaemia. The next commonly used agents were AGIs (acarbose and voglibose) in our study. AGIs such as acarbose seem to be particularly useful in newly diagnosed T2DM with excessive PPBG, because of their unique mode of action,

that is, to delay digestion and absorption of complex CHO and reduce postprandial rise in blood glucose levels.18 19 Usage of AGIs seems to be more in our study compared to that reported previously (26.4% in our study vs 7.6% in Sultana et al15). In an editorial published in the November 2010 issue of the Journal of Association of Physicians of India,20 the author expressed the need for therapeutic agents like AGIs that reduce postprandial hyperglycaemia and hyperinsulinaemia and also increase incretin levels (glucagon-like peptide-1) early in the course of T2DM. This strategy Entinostat may have a more prominent role in an Indian setting where the role of AGIs is even more significant as meal component is rich in CHO as seen in this study.20 However, we need to investigate further the benefit of various therapeutic interventions in high CHO-consuming Indian T2DM participants in a prospective randomised controlled study to examine this hypothesis. Limitation This study has some limitations; the cross-sectional design of the study does not allow us to make inferences about the cause (consumption of high CHO) and effect (glycaemic control, rise in PPBG). Another possible limitation of the study includes the small sample size, the possibility of measurement error of diet and covariates.